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Biomedical subjects

L G Elmqvist

Publications and source records attributed to L G Elmqvist.

18 recordsLinked to original sources
PubMed2001

Telemark skiing injuries: an 11-year study.

This study evaluated telemark injuries in a Swedish ski area in terms of injury ratio, location, and causes over time. During the seasons of 1989-2000 all injured telemark skiers ( n=94) who attended the medical center in Tärnaby, Sweden, within 48 h after the accident were registered and asked to fill in an injury form. A control group of noninjured telemark skiers were interviewed in the season of 1999-2000. The most common cause of injury was fall (70%) and the injury ratio was 1.2. There was a higher proportion of beginners in the injured population, and they had a fall/run ratio of 0.7, compared with 0.3 for average and advanced skiers. Ankle/foot injuries were most common (28% of injuries) followed by knee (20%) and head/neck (17%). The ankle/foot injuries decreased from 35% to 22% in the seasons 1989-1995 to 1995-2000. Beginners had more ankle/foot injuries than skilled participants. The severity of ankle/foot injuries classified as the Abbreviated Injury Scale group 2 or higher decreased from 33% to 21% during the study period. Twenty-seven percent used plastic and 73% leather boots. We found no association between boot material and ankle/foot injuries. The proportion of high boots with two or more buckles was 51%. High boots appeared to be protective against ankle/foot injuries. The proportion of high boots increased from 24% to 67% during the study period. Thus ankle/foot injuries were the most common injury location, but have decreased over time. The severity of these injuries has also decreased. A possible explanation could be the increased use of high boots.

Abbreviated Injury Scale↗
PubMed1997

CD4 lymphopenia in a patient with cryptococcal osteomyelitis.

Cryptococcus neoformans is a rarely reported cause of osteomyelitis. In most cases, no obvious underlying condition is found. Immunological laboratory data, however, are not generally available. In the present case of cryptococcal osteomyelitis, idiopathic CD4 lymphopenia was detected. This immunodeficiency is found in cases of disseminated cryptococcosis by chance. Possibly, it may be one so far unrecognized underlying condition in cryptococcal osteomyelitis.

Aged↗
PubMed1994

Over-the-top or tunnel reconstruction of the anterior cruciate ligament? A prospective randomised study of 54 patients.

We report a review of 54 patients with chronic anterior cruciate ligament rupture treated by patellar-quadriceps tendon graft augmented with polypropylene braid (Kennedy-LAD). The femoral placement of the graft was randomised to either a modified over-the-top (OTT) or a tunnel position obtained by an isometric drill guide (ISO). At the two-year follow-up both procedures had resulted in improvement of subjective knee function and activity level. Stereoradiographic measurements showed reduction of anteroposterior laxity to near normal in about one-third of the patients, but muscle strength and objective functional performance showed little or no changes. The OTT group had better subjective knee function. We were unable to confirm the theoretical advantages of the use of the drill guide, partly because it provided a tibial tunnel which was too anterior.

Adult↗
PubMed1993

Laxity after cruciate ligament injury in 94 knees. The KT-1000 arthrometer versus roentgen stereophotogrammetry.

We examined 94 knees with chronic anterior cruciate ligament injuries, 55 of which had been operated with ligament reconstruction, using the KT-1000 arthrometer (89 N anterior force) and roentgen stereophotogrammetry (RSA, 150 N anterior, 80 N posterior force). In intact knees the tibial displacement did not differ between the methods. In injured knees, operated or not, the KT-1000 recorded smaller AP translations and side-differences than RSA. Thus, the stabilizing effect of reconstructive surgery may be overrated, if evaluated with the standard KT-1000 technique.

Adolescent↗
PubMed1992

Lengthening of anterior cruciate ligament graft. Roentgen stereophotogrammetry of 32 cases 2 years after repair.

32 patients with old anterior cruciate ligament injuries were operated on with patellar tendon-prepatellar tissue-quadriceps tendon graft over the top without and with augmentation (Kennedy-LAD). The anteroposterior (AP) laxity was assessed preoperatively, and at 6, 12, and 24 months after the operation with roentgen stereophotogrammetry. 6 months postoperatively the instability had decreased 5.4 mm in the nonaugmented and 1.9 mm in the augmented group, but not to normal values. During the following 18 months the AP laxity increased and returned to the preoperative level. At 2 years, 28 of the 32 patients were considered good or excellent, according to the Lysholm score. There was a lack of correlation between AP laxity and functional tests.

Adult↗
PubMed1991

Ultra-low-field magnetic resonance imaging of acute cruciate ligament tears.

Ultra-low-field (0.04 T) magnetic resonance imaging (MRI) was evaluated in 15 patients with acute trauma to the knee and clinically suspected injuries of the cruciate ligaments. Subsequent arthroscopy was performed within 14 days (mean: 3 days) in 14 patients and after 3 mo in one patient. At arthroscopy/arthrotomy tears of the anterior cruciate ligament (ACL) were verified in 13 patients (11 complete, 2 partial tears). An additional tear of the posterior cruciate ligament (PCL) was found in one patient. All the tears could be demonstrated by MRI. There was one false positive MR diagnosis of ACL tear. It is possible with low-field MRI to diagnose injuries of the cruciate ligaments with good accuracy.

Acute Disease↗
PubMed1989

Knee extensor muscle function before and after reconstruction of anterior cruciate ligament tear.

Knee extensor performance, in 17 subjects with chronic anterior cruciate ligament (ACL) tear, was investigated preoperatively and on four different occasions postoperatively, using isokinetic measurements and electromyography of single maximum and repetitive manoeuvres. Preoperatively maximum mechanical output was comparatively low (injured leg), deteriorating further by 50% at fourteen weeks postoperatively. Endurance also falls markedly. Thereafter knee-extensor performance improved successively, mostly during intensive training (14-20 weeks postoperatively) irrespective of the training programme used. After one year, maximum performance was still unequal but the injured leg had achieved the "normal" preoperative noninjured value. Fatiguability/endurance level improved over preoperative values. Muscular work/integrated EMG was stable while EMG/t increased. Twenty weeks postoperatively quadriceps area was decreased to 69%, cf. noninjured control. The early postoperative loss of performance was evidently caused by loss of muscle mass. Neuromuscular relearning appears to be a sizable factor in later recovery. Isokinetic training does not offer any specific advantage in the early muscular rehabilitation after ACL reconstruction.

Adolescent↗
PubMed1988

Does a torn anterior cruciate ligament lead to change in the central nervous drive of the knee extensors?

Integrated surface electromyograms of the three superficial parts of the quadriceps and isokinetic knee extensor maximum torque and power production were recorded simultaneously and at different angular velocities in both legs in 11 male subjects with unilateral tear of the anterior cruciate ligament. The cross-sectional area (CSA) of the thigh and its muscular components were measured by computerized tomography. The principal findings were a small but significant decrease in quadriceps CSA on the affected side; a decreased active, but not passive, range of movement; decreased mechanical output, whether or not corrected for differences in CSA; and decreased electromyographic activity--particularly in rectus femoris. These findings suggest that the reason for the decreased maximum and total knee extensor performance seen in these patients is a change in knee joint receptor afferent inflow.

Adult↗
PubMed1988

Active knee motion after cruciate ligament rupture. Stereoradiography.

In 10 patients with an old injury of the anterior cruciate ligament, the three-dimensional movements of the knee joint were studied when the patients flexed their knees. Tibial motions were recorded using roentgen stereophotogrammetric analysis. Internal rotation and adduction of the tibia were reduced in the injured knees when compared with the intact knees; during flexion of the knee joint, the tibial intercondylar eminence occupied a more lateral and posterior position on the injured side. Our results may indicate that the knee joint is continuously exposed to abnormal stresses when the anterior cruciate ligament is torn.

Adult↗
PubMed1988

Three-dimensional instability of the anterior cruciate deficient knee.

Using roentgen stereophotogrammetry we have recorded the three-dimensional movements of the knee during an anteroposterior laxity test in 36 patients with torn anterior cruciate ligaments and in three cadaver knees. At 30 degrees of knee flexion and before loads were applied the tibia occupied a more laterally rotated position if the anterior cruciate ligament had been injured. When the tibia was pulled anteriorly knees with cruciate deficiency rotated more laterally and were more abducted than normal knees. Posterior traction induced lateral rotation in the injured knee and medial rotation in the intact one. Precise knowledge of the three-dimensional instability of the anterior cruciate deficient knee may be important when the laxity is evaluated only in relation to one of the three cardinal axes.

Adult↗
PubMed1986

Superoxide dismutase isoenzymes of the synovial fluid in rheumatoid arthritis and in reactive arthritides.

The activity of superoxide dismutase isoenzymes was determined in knee joint synovial fluid from 21 patients with rheumatoid arthritis, nine patients with reactive arthritides, and from 17 patients before arthroscopy or arthrotomy for suspected meniscal or ligament injury (controls). Extracellular superoxide dismutase was the major isoenzyme and accounted for about 80% of the total superoxide dismutase activity in the controls. The pattern of the superoxide dismutase isoenzymes was significantly different in rheumatoid arthritis, extracellular (EC) superoxide dismutase being half, CuZn superoxide dismutase double, and the total superoxide dismutase activity a third lower than the activity in the synovial fluid of the controls. The superoxide dismutase activities were similar in synovial fluid from the controls and from the patients with reactive arthritides. The total superoxide dismutase activity was almost three times higher in control synovial fluid than in normal human plasma, but 300 times lower than in human tissues.

Arthritis↗
PubMedDate not supplied

Reconstruction of the anterior cruciate ligament. Long-term effects of different knee angles at primary immobilization and different modes of early training.

The clinical results in 29 patients who had undergone ACL reconstruction with quadriceps-patellar tendon graft over-the-top were studied at an average of 28 months postoperatively. Postoperative immobilization was at either 30 degrees (N = 17) or 70 degrees (N = 12) of knee flexion for 6 weeks. All patients then followed a common preparatory training program for 8 weeks. In the 14th postoperative week the patients were put on either progressive resistance training (N = 12) or isokinetic training (N = 17) for 6 weeks, after which all had identical training. Independent of primary knee immobilization angle or training regimens, no differences could be demonstrated with respect to stability, range of motion, function, or isokinetic mechanical output. For all patients, Lysholm knee function score improved from 60.5 to 93.6 (P less than 0.001) and activity level from 3.9 to 6.3 (P less than 0.001). Isokinetic peak torque, contractional work, and mean power of the quadriceps at 30, 90, and 180 deg/sec were lower in the injured compared to the noninjured leg (78% to 90%; P less than 0.01) both preoperatively and at followup, and there were no significant differences between the preoperative and follow-up values. Clinical stability improved (P less than 0.001) in 19 of the 29 patients (66%) and in 11 of those 17 patients with early isokinetic training (65%). Performance tests were normal in 23 of 29 patients (79%), with minor abnormalities in the rest.

Adolescent↗
PubMedDate not supplied

Thigh musculature in relation to chronic anterior cruciate ligament tear: muscle size, morphology, and mechanical output before reconstruction.

Eighteen male patients who had untreated chronic ACL rupture were studied in order to evaluate thigh muscle size, morphology, and isokinetic performance of the quadriceps muscle. Computed tomography disclosed a 5.1% mean atrophy of the quadriceps (P less than 0.05), 2.1% slight hypertrophy of the hamstrings (P less than 0.05), and also nonsignificant changes of all other muscle areas of the injured thigh. Muscle morphology (m. vastus lateralis) was normal in 11 biopsy specimens, whereas minor abnormalities (irregular shape or hypotrophy) could be seen in the rest. Isokinetic mechanical output of the knee extensors was 71% to 87% of that of the noninjured limb (P less than 0.01), and the mechanical output corrected for differences in quadriceps cross-sectional area was significantly lower in the injured than the uninjured limb. As there were no significant correlations between isokinetic performance and muscle size or qualitative morphology or morphometric data, the strength decrease cannot be explained by muscle atrophy or structural changes per se. We conclude that nonoptimal activation of the muscles during voluntary contractions is probably the most important causative mechanism of the strength decrease found in patients who have chronic symptomatic ACL tear.

Adult↗
PubMedDate not supplied

Chronic anterolateral instability of the knee. A roentgen stereophotogrammetric evaluation.

The rotatory stability of the knee was investigated in 20 patients with a previous tear of the ACL. The three-dimensional movements of the tibia during the testing procedure were registered using roentgen stereophotogrammetric analysis. Changes of the tibial movements between an intermediate, an anterior, or a posterior tibial position were registered using tibial tractions in combination with a simultaneous external or internal rotatory torque. At 20 degrees of flexion the internal rotatory laxity was increased on the injured side. The external rotatory laxity did not significantly differ between the two sides. With anterior traction, the internal rotatory laxity increased on both the injured and the normal sides and became almost equal. The external rotatory laxity manifested a decrease which was most pronounced on the injured side. With posterior traction, the rotatory laxities decreased and did not significantly differ between the two sides. Analysis of the simultaneously occurring translations of the tibial plateau disclosed abnormal displacements of both the medial and the lateral tibial condyles on the injured side.

Chronic Disease↗
PubMedDate not supplied

Kinematics of active knee extension after tear of the anterior cruciate ligament.

Three-dimensional movements of the knees in 13 patients with unilateral old tears of ACLs were studied during extension. Roentgen stereophotogrammetric methods were used to measure tibial movements in the injured and the intact knees. Reduced internal rotation and adduction were recorded at the end of extension on both sides. The injured knees displayed increased anterior and distal displacements of the tibial intercondylar eminence. Abnormal tibial displacements in our patients indicate that the absence of the ACL is not completely compensated for during active extension past 30 degrees; close to the extended position, the tibial movements tend to normalize.

Adolescent↗